Depressive Disorders Flashcards
DSM-V definition of major depression disorder
5 or more of the following 9 symptoms have been present during same 2 week period. need at least one of the following: depressed mood or loss of interest/pleasure.
- depressed mood most of the day nearly every day
- markedly diminished interest or pleasure
- significant weight loss or weight gain
- insomnia or hypersomnia
- psychomotor agitation or retardation
- fatigue or loss of energy
- feelings of worthlessness or guilt
- diminished ability to think or concentrate
- recurrent thoughts of death/suicide
what does SIGECAPS stand for?
Sleep disturbance, Interest/pleasure reduction, Guilt, Energy loss, Concentration impairment, Appetite changes, Psychomotor symptoms, Suicidal ideation
how to tell difference between depression and normal sadness?
Depression has one of the following: Suicidality, Weight loss, Anhedonia, Guilt
atypical depression
more likely to have weight gain and hypersomnia. also leaden paralysis, carb cravings, rejection sensitivity
pseudodementia
cognitive symptoms in depressed elderly often misdiagnosed as dementia.
diurnal variation
more depressed in the morning, better in the PM. melancholic type depression (extreme anhedonia)
psychomotor symptoms
physical complaints: body aches, headaches. agitation vs. retardation, vegetative depression (slow, no energy)
seasonal affective disorder
MDD usually associated with shorter days in the winter. usually with atypical symptoms. Treat with full-spectrum light exposure, psychotherapy, antidepressants
Masked depression
depressed patient presenting with vague physical ailments but unaware/in denial of their depression. Seem stoic, seek primary care for psychomotor or somatic symptoms instead. consider diagnosis when no organic medical cause is identified. more typically seen in old people and OCD or narcissistic personalities
biological factors of depression
monoamine deficiency (decreased levels of DA, 5-HT, NE. Monoamine receptor excess theory. loss of neurotrophic factors (shrinking hippocampus). serotonin transporter gene mutations
psychosocial factors
ability to cope with life stressors, low self esteem, personality traits, addiction, learned helplessness, catastrophic loss, anger turned inward, incapacity via hibernating, learned helplessness and automatic thoughts, social disconnect
receptor numbers in depression
high number of receptors and/or low number of transmitter = depression
how long does it take to turn on a gene?
4-6 weeks. this is why antidepressants take a while to start working
stress-cortisol-depression
stress increases cortisol which decreases BDNF. this causes dead neurons. increasing BDNF decreases cortisol causing increased survival and growth of neurons.
what is seen in a functional MRI of depressed person
hypoactive dorsolateral prefrontal cortex. hyperactive amygdala (hyperactive limbic system)
